Healthcare Provider Details

I. General information

NPI: 1972054492
Provider Name (Legal Business Name): SAMANTHA STRATMAN OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2016
Last Update Date: 10/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 ROBINSON RD
CLINTON NY
13323-1418
US

IV. Provider business mailing address

245 MAIN ST APT H2
NEW YORK MILLS NY
13417-1292
US

V. Phone/Fax

Practice location:
  • Phone: 315-853-6090
  • Fax:
Mailing address:
  • Phone: 813-523-7069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number011545
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: